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General NPI Number Information
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NPI Number | 1578304275
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Entity Type | Individual
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Provider Name | GRANT TEICHMEIER DDS
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Gender | Male
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 304 W WASHINGTON AVE
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City | RICHLAND
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State | MO
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Zip | 65556-7101
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Country | US
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Telephone | 877-406-2662
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Fax |
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Provider Business Mailing Address
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Address Line | 145 4TH ST
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City | CAMDENTON
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State | MO
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Zip | 65020-7138
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Country | US
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Telephone | 308-440-4767
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 2024019728
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License Number State | MO
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